Intraoperative Monitoring of Visual Evoked Potential for Aneurysm Clipping Surgery
Intraoperative Monitoring of Visual Evoked Potential for Aneurysm Clipping Surgery
复制标题
动脉瘤夹闭手术中视觉诱发电位的术中监测
DOI：
10.2335/scs.36.350
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
K. Hongo
中科院分区：
文献类型：
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作者：
K. Kodama;T. Goto;A. Sato;K. Sakai;Yuichiro Tanaka;K. Hongo
我们术中监测6例动脉瘤夹闭术中视觉诱发电位（VEP），其中2例为IC类旁动脉瘤、2例IC后交通动脉（IC- pcoa）和2例大脑后动脉（PCA），这些动脉瘤存在视神经通路损伤的潜在风险。在异丙酚全静脉麻醉下，所有病例在整个手术过程中均获得稳定的波形。3例患者在临时动脉闭塞期间出现可重复的瞬态VEP波形下降，解除临时动脉闭塞后恢复。本组术后无视觉障碍。相反，在IC类旁动脉瘤患者视神经分离动脉瘤期间，VEP波形永久性下降。患者术后有严重的视力障碍。我们的研究表明，由动脉闭塞引起的视神经通路的短暂性缺血性功能障碍是在可逆的时间窗内检测到的；然而，在可逆时间窗内检测视神经损伤的机械损伤似乎很困难。术中监测VEP可预测术后视功能；VEP的可逆变化意味着视觉功能得以保留，特别是当供应视神经的动脉暂时闭塞而引起缺血时。
We intraoperatively monitored visual evoked potential (VEP) in 6 aneurysm clipping surgeries for 2 IC paraclinoid, 2 IC-posterior communicating artery (IC-PCoA) and 2 posterior cerebral artery (PCA) aneurysms, which had potential risk of optic pathway damage. Stable waveform was acquired throughout the procedures in all cases under total intravenous anesthesia with propofol. Reproducible transient VEP waveform decrease was observed during temporary artery occlusion, which recovered after release of temporary artery occlusion in 3 patients. No visual disturbance was encountered in this group postoperatively. On the contrary, VEP waveform decreased permanently during aneurysm dissection from the optic nerve in an IC paraclinoid aneurysm patient. The patient had severe visual dysfunction postoperatively. Our series revealed that transient ischemic dysfunction of the optic pathway caused from artery occlusion was detectable within a reversible time window; however, it seems difficult to detect mechanical damage of the optic nerve damage in a reversible time window. Intraoperative monitoring of VEP predicts postoperative visual function; reversible change in VEP means visual function is preserved, especially when the change is caused by ischemia that occurs when the artery that supplies the optic apparatus is temporarily occluded.
动脉瘤夹闭期间暂时闭塞垂体上动脉后视觉诱发电位丧失。
DOI：
--
发表时间：
2007
期刊：
J Neurosurg 107
影响因子：
--
作者：
Goto T;Tanaka Y;Kodama K;KusanoY;Sakai K;Hongo K
通讯作者：
Hongo K